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Hematologic Malignancies • Medical Oncology • Myeloma • NCI-CCC Tumor Board Question • Hematology • University of Chicago • NCI-CCC Myeloma Tumor Board Question
How would one alter therapy in a transplant-ineligible AL amyloidosis with less than a complete response to six cycles of Dara-CyBorD?
Would you continue with daratumumab maintenance per ANDROMEDA or switch regimen?
Answer from: Medical Oncologist at Academic Institution
If the patient has achieved deep VGPR (but perhaps not CR due to interference of dara), it is probably reasonable to continue dara maintenance as per ANDROMEDA as long as the patient is also clinically improving. If the response has not reached this level or the patient has not had evidence of impro...
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Answer from: Medical Oncologist at Academic Institution
Since the patient has responded, I would continue therapy. I would consider either Dara monotherapy based on ANDROMEDA study or consider Dara with Vd if the patient is able to tolerate to get to a CR. If the patient is symptomatic and unable to tolerate therapy, I would consider changing treatment.